Most people might shy away from an opportunity to lead an organization that was undergoing a major change in operations and had an IT structure that needed to be modernized. In fact, most wouldn’t view it an “opportunity,” but a risk that’s too great. Jennifer D’Angelo, however, had a different take. She viewed New Bridge Medical Center (which had just selected Care Plus Bergen, Inc. as its operator) as a “diamond in the rough,” and welcomed the task of stabilizing and enhancing the infrastructure to enable providers to more effectively care for patients.
In this interview, D’Angelo talks about why she “jumped” at the chance to help develop a new vision for New Bridge, the importance of involving stakeholders at every level to provide behavioral care throughout the continuum, and how they’re reaching out to the community to increase awareness of the services offered. She also discusses the shift the CIO has gone through, and why she believes being a hands-on leader is the way to go.
- About New Bridge MC
- Stepping in with “many projects already motion”
- Focus on stabilizing & enhancing the infrastructure
- “It continues to be a sprint.”
- Importance of physician champions
- Being a “very hands-on CIO.”
- Jersey Health Connect HIE
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I walked into many projects that were already in-flight and in motion, so it was really trying to get a sense of what the hospital needs were, getting quickly versed on the projects that were already approved and in progress, and trying to supplement and bring in new team members to support these initiatives.
We’re continuing to improve the infrastructure and applications across the board, and obviously, identify new opportunities for technology and find ways to leverage technology.
We’re building our backend infrastructure for disaster recovery and making sure we have systems that are reliable and uptimes that are sustainable so that we can keep the facility running with no interruptions.
I like to talk to the physicians and the clinical team as we’re developing systems to make sure from an operational standpoint that we’re meeting their needs, and that it’s not just technology-driven.
Gamble: Thank you so much for taking some time to speak with healthsystemCIO.com.
Gamble: To get us started, can you talk about New Bridge Medical Center? Obviously, this is an organization that has gone through quite a bit of change. So, can you just give us some background?
D’Angelo: Absolutely. In terms of the facility itself, we’re the largest hospital in New Jersey and fourth largest public hospital in the nation. We’re located in Bergen County, which is I think a fun fact, because people really don’t realize that when they look at some of the health systems in New Jersey. We have 1,070 beds, and were founded in 1916, originally to treat patients with contagious diseases. It’s just an incredible journey. The facility has been here for such a long time and often is not looked at from a state perspective as the largest hospital, so we’re really proud of that.
Gamble: Can you talk about the recent history and some of the changes that have been made within the organization?
D’Angelo: Yes. Historically, it’s been a county-owned facility, and it has been run by a for-profit management company that had been here for 19 years. About two years ago, I believe, the County started the process to identify a new management company. Care Plus Bergen, Inc. was selected from many contenders. It’s comprised of Care Plus New Jersey, Integrity House, and Rutgers Biomedical and Health Sciences. The contract started on Oct. 1, 2017. On Oct. 2, the facility was renamed as New Bridge Medical Center (formerly known as Bergen Regional, and before that, Bergen Pines).
As I mentioned, Care Plus Bergen Inc. became the new nonprofit manager of the medical center after a very rigorous RFP process performed by the County of Bergen to identify a new management entity. We now have a great innovative alliance between three partners — Rutgers Biomedical and Health Sciences, Integrity House, and Care Plus New Jersey. New Bridge Medical Center is owned by the County of Bergen, but managed day to day by Care Plus Bergen, Inc., focusing on strengthening the hospital’s core services: behavioral health, substance abuse and addiction treatment, long term care, and acute care, while ensuring greater access to primary care for Bergen Country residents. New Bridge continues to play a critical role in healthcare delivery for patients and families, not only in Bergen County, but across the State of New Jersey. That’s a very high-level overview of the management structure and us really launching multiple initiatives as of Oct. 1.
Gamble: In terms of governance, who do you report to?
D’Angelo: I report directly to the Medical Center’s President and CEO [Deborah Visconi], and we are all employees of Care Plus Bergen, Inc.
Gamble: What do you have in terms of IT staff?
D’Angelo: Our IT staff is an ever-evolving structure, so I’m going to reference my organizational chart. Under my area in the Information Services Department, we have a Director of Security and an Information Security Officer, so very strong emphasis on security in healthcare. We have a Director of Applications and we have specialists that handle every application that’s run throughout the hospital. We have a Director of Operations, who manages our network infrastructure, as well as help desk, technicians 1, 2, 3 levels, and network engineering. We also have a really strong clinical informatics side. We have a Director of Clinical Informatics and Clinical Informatics Nurses that work within the department, and we’re actively recruiting for a CMIO. I’m very happy to say we’ve been able to add, in my short time here, some really critical staff to the department to help leverage and manage some major IT initiatives that we have in play right now.
Gamble: Right, and we’ll definite get into that. Going back a little bit, when you started back in October, what were your key priorities coming into the role?
D’Angelo: There were many key priorities simultaneously happening. The County had engaged a third party IT consulting company during the RFP process and search for the new management company to do a complete assessment to see, from a technology standpoint, where the facility needed to be so that we would have the ability once we were on-boarded to get things started from an IT infrastructure standpoint. And so for me, it was onboarding and focusing on infrastructure and critical applications right out of the gate. I walked into many projects that were already in-flight and in motion, so it was really trying to get a sense of what the hospital needs were, getting quickly versed on the projects that were already approved and in progress, and trying to supplement and bring in new team members to support these initiatives.
Gamble: People often talk about hitting the ground running, but it sounds like you had to hit the ground sprinting.
D’Angelo: Yes, it was a ‘hit the ground sprint.’ It continues to be a sprint, and we’re making some great strides. We’ve had some significant milestones met, and we’re continuing to improve the infrastructure and applications across the board, and obviously, identify new opportunities for technology and find ways to leverage technology in this hospital — this unique facility with behavioral health, medical detox, acute inpatient and long term care beds. And so we have a variety of programs that sit under this organization’s umbrella, which is really terrific to be a part of those service lines within the hospital.
Gamble: So you’re about four months in. What would you say are your biggest priorities for this year?
D’Angelo: From a security standpoint, we have allocated resources emphasizing cybersecurity efforts, which includes educating staff on how to safeguard privacy. At the same time, we’re doing a lot of modernization. And so culturally, we’re trying to communicate as best we can to educate staff as they continue to use technology in a different way here. With that increased use of technology comes a tremendous amount of education.
One of our main focuses is security from the standpoint of email and infrastructure, and educating the staff on ePHI — what does that mean, and how do we continue to give quality care and communicate with our partners within the organization and outside the facility securely and appropriately? Making sure that our information remains secure is a very big initiative here and is at the forefront for everyone.
From a technology standpoint, we’re building our backend infrastructure for disaster recovery and making sure we have systems that are reliable and uptimes that are sustainable so that we can keep the facility running with no interruptions. We’re working a lot on stabilizing and enhancing the infrastructure so that we’re comfortable that the layers we’re building here for sustainability are keeping us secure, and that by having offsite locations as part of that process, we can be fully redundant across the board. We’ve been doing a lot of onsite/offsite initiatives and making sure that we’re fully connected.
I break it down into three buckets: security, infrastructure, and applications. From an application standpoint, we’re in the process of going through a major EMR upgrade. We use McKesson’s Paragon system, and we’re upgrading to their latest version, which is a huge initiative here. We have a team of wonderful people from Allscripts onsite, working with us and with our partners to develop the best use of that application throughout the hospital.
Gamble: What’s the approximate timeline as far as that upgrade?
D’Angelo: We are in the process of doing that upgrade, and have been for the past several months. We’re looking to go live on the new system during the second quarter.
Gamble: Okay, so a lot going on several fronts. One area I wanted to get into is some of the biggest differences when it comes to IT adoption in the behavioral health setting. What would you say are the key considerations?
D’Angelo: I’ve worked in behavioral health before. In terms of EMR adoption, from a systems perspective, these physicians work in many places. They have a lot of comparisons now as opposed to years ago where EMRs were a nice to have. It wasn’t mandatory to do day-to-day business, and so I know there’s been a lot of talk around behavioral health and what’s appropriate from an electronic standpoint.
I think we’re in a really great place with that. Getting physicians onboard and having them as supporters and champions of behavioral health EMRs is critical to the process. Trying to make a system function as closely to their workflow as possible can be difficult, and so it’s trying to find that balance, which is achievable by building physician relations. For me, I’m a very hands-on CIO. I like to be on the units and in the departments. I like to talk to the physicians and the clinical team as we’re developing systems to make sure from an operational standpoint that we’re meeting their needs, and that it’s not just technology-driven. It’s no longer the older way of thinking where you have your checklist — it works on the network, it’s compliant, it’s secure, but does that necessarily mean it’s easy for my end users and that it meets their operational needs? Those are very different conversations that have to happen.
I look at it from a standpoint of, who are my key stakeholders in this? It’s meeting with them to make sure we have high adoption rates as we continue to roll out this EMR upgrade, and developing committees so that we’re able to get participation from all levels of behavioral health to ensure they have input in the process and can really own it. Bringing them in from the very beginning and setting up steering committees to discuss things that need to be decided is a much better approach, and really increases the adoption of utilization.
We all know there isn’t one system that fully meets everybody’s requirements 100 percent of the time. Unfortunately, for a physician that’s used to handwriting a prescription and handing it off to the next person — which literally takes seconds to do — when you convert that to an electronic process, it definitely takes more time. But we try to explain that although it takes more time initially until they come up with prescribing patterns and we customize it to fit their need, it actually ends up saving time from a trickle-down effect. And so from a quality standpoint, and from patient care and continuity standpoint, it really is enhancing the quality of care and care delivery for maybe 50 people that will touch that medical record.
Gamble: What about patient engagement? It seems like there’s a lot of potential in the behavioral health space for improving ways to communicate and interact with patients.
D’Angelo: Right. There’s a great opportunity for patient engagement, which is much easier when you’re fully electronic. There’s that balance of getting patient engagement where you have information that’s going in to an electronic medical record, but also the face-to-face time that you still need to have so that the patient is part of the treatment planning process. That’s not necessarily always technology-driven, but a shift from a workflow and operations standpoint where the patient is at the forefront, and they need to be part of their care delivery and have a say in the treatment planning process. This allows for that.
Another exciting thing we’re doing here is we are part of Jersey Health Connect HIE. It’s really exciting for us as a facility and to leverage the utilization of the health information exchange to assist not only us with our care delivery, but when the patient is discharged, to have a place where patients can go to access their records. Also, from a provider standpoint, it’s connecting with our partners here to be able to exchange data in a secure fashion to help with the continuity of care and care delivery, as well as coordination of their care on discharge.
Joining Jersey Health Connect gives us the opportunity to coordinate care with many providers that are part of that HIE, which is very new and exciting for us.
Gamble: From what I have heard, it’s a pretty robust HIE and so I’m sure that’s really exciting.
D’Angelo: From a state perspective, I’m a board member of New Jersey HIMSS and I’m involved with many organizations in the state like HCANJ, NJHA to try to get providers the knowledge and awareness of what HIEs can provide for all of us collectively if we’re actively participating and really driving that message. I’m a big advocate for utilization of data exchange to streamline patient information across the board in a secure way to properly coordinate care.